Appointment Request

Please fill out the following form
in order to request an appointment.

Please note that acceptable forms of payment are cash, credit/debit card and HSA/FSA cards.

We do not accept insurance.

After you click submit, please proceed to the next page to complete advanced payment for your initial consultation.

Note: Consultations are by appointment only and are scheduled within our operating hours of

9 a.m. - 4 p.m. only

To secure your appointment, please submit the full balance due for your initial consultation of $299 by clicking on the button below, which will direct you to the payment page. Please note that this deposit is non-refundable but guarantees that no additional charges will be due at the time of your appointment.
If you are booking for Botox/Microneedling or a Wellness Boost Shot (in office injection), no deposit is required. Once your form and payment are received, we will contact you within 24 hours to arrange an appointment date and time that works best for you within our operating hours.